Devrim AKSEKİ, Halit PINAR, Osman KARAOĞLAN

Menisküs yırtıklarının klinik tanısı ve eşlik eden ön çapraz bağ lezyonunun tanıya etkisi

Amaç: Birçok spor yaralanmasında menisküs ve ön çapraz bağ (ÖÇB) yırtıkları birlikte görülür. Bu çalışmada, eşlik eden ÖÇB yırtığının menisküs yırtığı klinik tanısını etkileyip etkilemediği araştırıldı. Çalışma planı: Klinik olarak iç menisküs yırtığı (grup A; 26 hasta; 22 erkek, 4 kadın; ört. yaş 26.6; dağılım 18-67) ya da iç menisküs yırtığı ile birlikte ÖÇB lezyonu düşünülen (grup B; 17 erkek; ört. yaş 28.2; dağılım 19-49) olgular ileriye dönük olarak incelendi. Başka lezyonu olan olgular çalışmaya alınmadı. Klinik olarak, eklem aralığı duyarlılığı (EAD), McMurray testi ve hiperekstansiyon testi uygulandı. Ameliyat öncesinde konan tanılarla artroskopik tanılar karşılaştırıldı ve klinik menisküs testlerinin doğruluğu hesaplandı. Her iki grup Lysholm skalasındaki parametreler ve toplam Lysholm skorları açısından karşılaştırıldı. İstatistiksel analizler için Fischer exact testi ve Mann-Whitney U-testi kullanıldı. Sonuçlar: Medial EAD, A grubunda %82, B grubunda %73 oranında bulundu. McMurray testi A grubunda olguların %82'sinde, B grubunda %62'sinde; hiperekstansiyon testi A grubunda %73, B grubunda %61 oranında doğru sonuç verdi. Toplam Lysholm skoru A grubunda 69, B grubunda 61 bulundu; aradaki fark anlamlı idi (p

Anahtar Kelimeler:

Diz yaralanmaları, Duyarlılık ve özgüllük, Spor yaralanmaları, Artroskopi, Diz eklemi, Manyetik rezonans görüntüleme, Menisküs, tibial, Tanı, Fizik muayene, Ön çapraz bağ

The accuracy of the clinical diagnosis of meniscal tears with or without associated anterior cruciate ligament tears

Objectives: Meniscal tears and anterior cruciate ligament (ACL) tears commonly coexist in sports injuries. The purpose of this study was to analyze the influence of ACL deficiency on our ability to diagnose meniscal tears. Methods: The study included patients with a clinical diagnosis of medial meniscal tears with (group A; 26 patients; 22 males, 4 females; mean age 26.6 years; range 18 to 67 years) or without (group B; 17 males; mean age 28.2 years; range 19 to 49 years) associated ACL tears. Patients with lesions other than meniscal or ACL tears were excluded. Clinical evaluations were made with the use of medial joint line tenderness, McMurray, and hyperextension tests. Preoperative diagnoses were compared with arthroscopic results and the accuracy of the tests used were calculated. The two patient groups were also compared with regard to the Lysholm scale parameters and total Lysholm scores. Fisher's exact test and Mann-Whitney U-test were used for statistical analysis. Results: Medial joint line tenderness was present in 82% in group A, and 73% in group B. McMurray test was positive in 82% in group A, and 62% in group B; hyperextension test was positive in 73% in group A, and 61% in group B. The total Lysholm scores were significantly different, being 69 in group A, and 61 in group B (p<0.05). Conclusion: Our findings suggest that the accuracy of a clinical diagnosis of a meniscal tear is decreased by the presence of an ACL tear. The coexistence of meniscal and ACL tears requires a more careful clinical evaluation and a more frequent need for magnetic resonance imaging.

Keywords:

Knee Injuries, Sensitivity and Specificity, Athletic Injuries, Arthroscopy, Knee Joint, Magnetic Resonance Imaging, Menisci, Tibial, Diagnosis, Physical Examination, Anterior Cruciate Ligament,

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